Publications by authors named "Estela Kiouri"

Aims: Three physical signs, namely tendon xanthomas, corneal arcus and xanthelasma, have been associated with heterozygous familial hypercholesterolemia (heFH). The prevalence and clinical significance of these signs are not well established among contemporary heFH individuals. This study explored the frequency as well as the association of these physical signs with prevalent atherosclerotic cardiovascular disease (ASCVD) in heFH individuals.

View Article and Find Full Text PDF

Background: Familial hypercholesterolemia (FH) and obesity are well-established risk factors of atherosclerotic cardiovascular disease (ASCVD). Despite high prevalence, their joint association with ASCVD remains largely unknown.

Objective: To investigate the association of obesity with prevalent ASCVD in individuals with heterozygous FH (HeFH) enrolled in the Hellenic Familial Hypercholesterolemia Registry (HELLAS-FH).

View Article and Find Full Text PDF
Article Synopsis
  • Familial hypercholesterolemia (FH) significantly increases the risk of atherosclerotic cardiovascular disease (ASCVD), with older patients (over 65) experiencing more ASCVD risk factors, such as hypertension and type 2 diabetes, compared to younger patients.
  • In a study of 2,273 adults, elderly FH patients showed a higher prevalence of established ASCVD (38.4%) and coronary artery disease (CAD) compared to their younger counterparts, even when adjusted for other risk factors.
  • Although elderly patients received more intense lipid-lowering treatments with lower post-treatment LDL-C levels, both elderly and younger groups had similarly low rates of achieving LDL-C targets, highlighting the need for improved early
View Article and Find Full Text PDF
Article Synopsis
  • Familial hypercholesterolemia (FH) and type 2 diabetes mellitus (T2DM) both increase the risk of atherosclerotic cardiovascular disease (ASCVD), but the relationship between T2DM and ASCVD in FH patients is not well understood.
  • In a study involving 1,719 adults with FH, 7.2% were diagnosed with T2DM, and those with T2DM showed significantly higher rates of ASCVD, coronary artery disease, and stroke compared to those without T2DM.
  • T2DM was strongly linked to a higher prevalence of ASCVD after adjusting for various risk factors, suggesting the need for enhanced risk assessment and treatment strategies for FH patients with T2DM.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the link between lipoprotein(a) [Lp(a)] levels and the prevalence of atherosclerotic cardiovascular disease (ASCVD) in adults with familial hypercholesterolemia (FH).
  • In a sample of 541 patients, those with higher Lp(a) concentrations showed a notable increase in ASCVD prevalence, with rates rising from 9.4% in the lowest tertile to 20.6% in the highest.
  • The findings suggest that elevated Lp(a) levels are an important risk factor for ASCVD in individuals with FH, emphasizing the need for monitoring and addressing Lp(a) in this population.
View Article and Find Full Text PDF

Background: The 2019 European guidelines (ESC/EAS) for the treatment of dyslipidaemias recommend more aggressive targets for low-density lipoprotein cholesterol (LDL-C) in patients with familial hypercholesterolemia (FH). Current lipid-lowering treatment is often inadequate to achieve these targets.

Methods: Data from the HELLAS-FH registry were analysed to assess achievement of LDL-C targets in adults with FH based on the 2019 ESC/EAS guidelines.

View Article and Find Full Text PDF

Hyperhomocysteinemia has been established as a risk factor for cardiovascular events. This case of a 23-year-old male, presenting with acute coronary thrombosis and unremarkable past medical history, highlights the importance of measuring homocysteine levels in young individuals with acute coronary syndromes, especially those without conventional risk factors. < Hyperhomocysteinemia could be rarely the only risk factor causing an acute coronary syndrome, especially in very young individuals; Optical coherence tomography could provide valuable information regarding the cause of occlusion in an unexpected clinical presentation; Gene testing for thrombophilia should be considered for very young individuals with acute coronary syndrome without conventional risk factors; Randomized controlled trials have failed to prove a clinical benefit in patients treated with folic acid.

View Article and Find Full Text PDF

High-Density Lipoprotein cholesterol (HDL-C) levels do not correlate well with Coronary Artery Disease (CAD) risk, while HDL functionality affects atherogenesis and is a better prognostic marker for CAD. Often, the extreme HDL-C levels have a multigenic origin. Here, we searched for single-nucleotide polymorphisms (SNPs) in ten genes of HDL metabolism in a Greek cohort with very low (<10th percentile, n = 13) or very high (>90th percentile, n = 21) HDL-C.

View Article and Find Full Text PDF

Background: Familial hypercholesterolemia (FH) is characterized by elevated low-density lipoprotein cholesterol (LDL-C) levels and increased cardiovascular disease (CVD) risk. FH patients often have increased lipoprotein(a) [Lp(a)] levels, which further increase CVD risk. Novel methods for accurately calculating LDL-C have been proposed.

View Article and Find Full Text PDF

Background: In randomized clinical trials, proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) effectively reduce low-density lipoprotein-cholesterol (LDL-C) with a favorable tolerability and safety profile. Our purpose is to provide real-world data regarding the indications, efficacy and safety of PCSK9i.

Methods: The cohort comprised 141 patients who attended the lipid clinic of 3 hospitals in Greece and started using PCSK9i.

View Article and Find Full Text PDF

Background: Homocysteine (Hcy) is considered a risk factor for cardiovascular disease.

Objective: To explore the long-term prognostic value of Hcy in patients with stable coronary artery disease (CAD) in the era of statins.

Methods: A total of 876 consecutive patients with stable CAD were recruited and followed up for a median of 6.

View Article and Find Full Text PDF

Background: Heterozygous familial hypercholesterolemia (HeFH) and combined hyperlipidemia (CHL) phenotype are associated with premature myocardial infarction (MI).

Objective: To assess the prevalence of HeFH and CHL phenotype among young survivors of MI and compare patients' characteristics with these 2 lipid disorders.

Methods: We recruited 382 young survivors of MI (≤40 years).

View Article and Find Full Text PDF

Background And Aims: The latest guidelines from the American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) proposed a new "extreme-risk" category of patients, for whom a low-density lipoprotein cholesterol (LDL-C) level <55 mg/dL (1.4 mmol/L) is advised. We aimed to identify the proportion of patients with stable coronary artery disease (CAD), who are at extreme cardiovascular (CV) risk, and explore how achievable is the new LDL-C goal.

View Article and Find Full Text PDF